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"Efektivitas terapi kanker kapasitansi listrik (ECCT : Electro-Capacitive Cancer Treatment) pada penderita kanker otak bergantung pada intensitas distribusi medan listrik pada area target yang dipengaruhi oleh konfigurasi elektroda, tegangan dan frekuensi medan listrik. Intensitas medan listrik dan densitas energi listrik yang timbul pada jaringan kanker diupayakan mampu menciptakan efek elektrodestruksi yaitu sebesar <200 V/m atau <1,77 x10-7 J/m3. Pada penelitian ini, intensitas medan listrik dan densitas energi listrik pada jaringan kanker otak di lima posisi yang berbeda di analisis untuk sepuluh parameter dengan enam konfigurasi elektroda (apparel A, B, C, D, E, dan F), dua tegangan (20 Vpp dan 30 Vpp) dan dua frekuensi medan listrik yang berbeda (100 kHz dan 200 kHz). Lima posisi jaringan kanker otak yang dianalisis yaitu berada di otak tengah, otak kanan, otak kiri, lobus frontal, serta lobus occipital dan otak kecil. Penelitian dengan simulasi dilakukan dengan menggunakan Comsol Multiphysics 3.5 berbasis Metode Elemen Hingga. Sedangkan penelitian eksperimen menggunakan sensor microstripline patch antenna (MPA) yang dikembangkan dan terhubung ke sistem akuisisi data dan komputer. Keenam konfigurasi elektroda diterapkan pada vessel prisma rectangular dan model kepala. Hasil simulasi dan eksperimen untuk vessel kotak pada medium udara menunjukkan distribusi medan listrik yang sebanding. Sedangkan simulasi dengan model kepala menunjukan masing-masing apparel efektif secara spesifik pada posisi kanker tertentu. Apparel A efektif untuk posisi kanker pada otak tengah, lobus frontal dan occipital. Apparel B efektif untuk posisi kanker pada otak tengah. Apparel C efektif untuk posisi kanker pada otak kanan. Apparel D efektif untuk posisi kanker pada otak kiri. Apparel E efektif untuk posisi kanker pada lobus frontal. Apparel F efektif untuk posisi kanker pada lobus occipital dan otak belakang.

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The effectiveness of ECCT for brain cancer depend on the intensity of the electric field distribution on the target area that is affected by the configuration of electrodes, voltage and frequency of the electric field. The intensity of the electric field and the electric energy density arising on the cancerous tissue have to be able to create the effect of the electrodestruction <200 V/m or <1,77 x10-7 J/m3. In this study, the intensity of electric field and density of electric energy on the brain cancer tissues at five different positions in the analysis to ten parameters with six electrodes configuration (apparel A, B, C, D, E, dan F), two voltage (20 Vpp and 30 Vpp) and two different electric field frequencies (100 kHz and 200 kHz). The five positions of the brain cancer tissues were analyzed which is in mid brain, right hemisphere, left hemisphere, frontal lobe, occipital lobe and cerebellum. In this research, the simulation performed using Comsol Multiphysics 3.5-based Finite Element Method. While the experiments using sensor microstripline patch antenna (MPA) developed and connected to the data acquisition system and computer. The sixth configuration of electrodes applied to the rectangular prism vessel and head models. Simulation for experiment and experimental results for rectangular prism vessel on the medium of the electric field distribution of the air shows are comparable. While simulations with models of the head showed each apparel specifically effective in cancers at the certain position. Apparel A effective for cancer of the mid brain, the frontal lobe and the occipital lobe. Apparel B effective for brain cancer in the mid brain. Apparel C effective for brain cancer in the right hemisphere. Apparel D effective for cancer of the left hemispehre. Apparel E effective for cancer in the frontal lobe. Apparel F effective for cancer of the occipital bone and cerebellum."

"ABSTRAKDengan menggunakan TLD dan dosimeter dioda EDD - 53G, telah diukur dosisorgan kritis mata, tiroid, medula spinalis , dan gonad pada berbagai perlakuanradioterapi dengan sinar X 6 MV. Pengukuran dilakukan pada fantom rando yangdiberi simulasi perlakuan radioterapi dengan berbagai jenis kanker, utamanya kankernasofaring. Perencanaan simulasi terapi 3 D dilakukan dengan TPS ISIS berdasarkandata hasil pengamatan pada beberapa pasien kanker nasofaring yang telah menjalaniradioterapi di RSPAD. Perlakuan diberikan dengan 2 lapangan plan parallel dan teknikSAD (source axis distance), ukuran lapangan radiasi 18.5 x 17 cm2, dosis preskripsi 2Gy/fraksi. Sesuai dengan perlakuan pada pasien, kemudian lapangan diperkecil untukmelindungi medulla spinalis, menjadi 9 x 16 cm2. Dengan cara yang sama, dosis organkritis ditentukan dari simulasi radioterapi kanker paru, tulang bahu, abdomen, pelvisdan tulang paha. Perencanaan setiap perlakuan diakukan berdasarkan data seorangpasien yang telah menjalani radioterpi di RSPAD . Pada umumnya dosis organ kritisyang berjarak 0 – 4 cm dari tepi lapangan berbeda dengan hasil kalkulasi TPS sampai61% bila diukur dengan TLD, dan berbeda sampai 80% bila diukur dengan diode.Untuk organ yang terletak relatif lebih jauh dari tepi lapangan radiasi, hasil pengukurandengan kedua dosimeter menunjukkan hasil sama, berbeda sampai lebih 100% dengankalkulasi TPS. Dosis pada pasien 5000 cGy, maka mata menerima dosis mencapai 209cGy pada perlakukan kanker nasofaring dan mencapai 400 cGy pada perlakukan kankerotak. Organ kritis tiroid dimungkinkan menerima dosis dari perlakuan kanker paru,kanker nasofaring, dan kanker tulang bahu, berturut turut mencapai 284 cGy, 192 cGy,dan 312 cGy. Organ kritis Gonad pada perlakuan radioterapi kanker abdomen menerimadosis sebesar 524 cGy dan kanker sarkoma tulang paha mencapai 372 cGy.

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ABSTRACTBy using TLD and diode dosimeter EDD - 53G, critical organ doses weremeasured eye, thyroid, spinal cord, and gonads at various radiotherapy treatment with 6MV X-rays. Measurements were taken at rando phantom given radiotherapy treatmentsimulations with various types of cancer, especially nasopharyngeal cancer. 3 Dtreatment planning simulations performed with ISIS TPS based observed data on someof nasopharyngeal cancer patients who had undergone radiotherapy in the armyhospital. Treatment was given with 2 field parallel plan and technique of SAD (sourcedistance axis), the radiation field size 18.5 x 17 cm2, prescription dose 2 Gy / fraction.In accordance with the patient's treatment, then the field is reduced to protect the spinalcord, at 9 x 16 cm2. In the same way, the dose of the critical organ is determined fromthe simulation radiotherapy of lung cancer, bone shoulder, abdomen, pelvis and femur.Planning any transactions are carried out based on the data treatment of a patient whohad undergone radiotherapy at the RSPAD. In general, the critical organ dose within 0-4cm from the edge of the field in contrast to the results of calculations TPS to 61% whenmeasured with the TLD, and vary up to 80% when measured with the diode. For anorgan that is located relatively far from the edge of the radiation field, with bothdosimeter measurements showed similar results, approximately over 100% differentfrom the TPS calculations. The dose given to patient at 5000 cGy, the eyes receiveddose until 209 cGy at simulation nasofaring cancer and until 400 cGy at simulationbrain cancer. Critical organs received doses of thyroid possible treatment of lung cancer,nasofaring cancer, and shoulder bone cancer, the dose received in a row to reach 284cGy, 192 cGy, and 312 cGy. Gonad organ critical in the abdomen cancer radiotherapytreatment received a dose of 524 cGy and bone sarcoma cancer at 372 cGy."

"Medan listrik dengan frekuensi 100-200 kHz dan tegangan 10-15 volt memiliki pengaruh terhadap sel yang sedang mengalami pembelahan. Electrical Capacitive Cancer Treatment (ECCT) adalah perangkat terapi kanker yang menghancurkan sel kanker dengan menggunakan efek medan listrik statis. Penelitian ini bertujuan untuk mengevaluasi desain elektroda kapasitif untuk meningkatkan efektivitas ECCT pada terapi kanker payudara dengan menganalisis intensitas dan energi distribusi medan listrik di jaringan payudara. Analisis distribusi medan listrik dilakukan dengan simulasi menggunakan Comsol Multiphysics 3.5 berbasi metode elemen hingga. Hasil penelitian menunjukkan bahwa desain elektroda kapasitif yang dikembangkan efektif pada semua posisi kanker di jaringan payudara (kuadran lateral superior, lateral inferior, medial superior, medial inferior, central).

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Electric field with a frequency of 100-200 kHz and a voltage of 10-15 volts has an influence on the cell division. Electrical Capacitive Cancer Treatment (ECCT) is a cancer therapy device that destroys cancer cells using static electric field effects. This study aimed to evaluate the capacitive electrode design to improve effectiveness of ECCT on breast cancer therapy by analyzing intensity and energy distribution of electric field in breast tissue. Analysis of electric field distribution was done by simulation using COMSOL Multiphysics 3.5 based on the finite element method. The results showed that the developed capacitive electrode design effective for all cancers position in the breast tissues (lateral superior quadrant, lateral inferior, medial superior, medial inferior, central)."

"[Telah dilakukan penelitian dalam mengevaluasi pengaruh material homogen dan inhomogen pada teknik IMRT (Intensity Modulated Radiotherapy) menggunakan modalitas Fan Beam CT (FBCT) dan Cone Beam CT (CBCT) terhadap Gamma Index (GI). Perencanaan ulang dilakukan untuk 5 pasien kanker paru kanan pada modalitas FBCT dan CBCT menggunakan TPS Phillips Pinnacle energi foton 6 MV. Menggunakan Teknik IMRT 30 segmen, 50 segmen, dan 70 segmen untuk perencanan terapi. Calculation Grid Resolution (CGR) 0.2 cm dan 0.4 cm digunakan sebagai resolusi dalam perhitungan dosis. Serta kalibrasi bilangan CT (KBC) FBCT, CBCT, dan linear dipergunakan sebagai koreksi CT density number. Pengukuran plannar dose untuk evaluasi Gamma Index (DD 2% / DTA 2 mm, passing rate 90%) dilakukan pada SAD 100 cm dengan material homogen dan inhomogen pada kedalaman 1.5 cm, 5 cm, dan 10 cm. Didapatkan deviasi nilai rata-­‐rata GI antara CGR 0.2 cm dengan 0.4 cm material homogen modalitas FBCT dan CBCT berturut-­‐tutut ≤1.46% dan ≤ 1.13%. Serta deviasi pada material inhomogen sebesar ≤ 2.54% (FBCT) dan ≤ 1.74% (CBCT). Deviasi Nilai rata-­rata GI antara FBCT dengan CBCT dengan CGR 0.2 cm berturut-­turut ≤ 1.95% (homogen) dan ≤ 2.36% (inhomogen). Dan deviasi Nilai rata-­‐rata GI antara material homogen dan material ekuivalen homogen sebesar ≤ 0.80%. Dari hasil penelitian yang didapat, bahwa evaluasi Gamma Index dapat dipengaruhi oleh jumlah segmen, modalitas CT, kalibrasi bilangan CT, Calculation Grid Resolution, dan kedalaman material.

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These Studies have been carried out to evaluate the effect of a homogeneous and inhomogeneous material on IMRT Technique (Intensity Modulated Radiotherapy) using Fan Beam CT (FBCT) and Cone Beam CT (CBCT) for the Gamma Index (GI). The Phillips Pinnacle treatment plan was used to replan 5 patients on right side of lung cancer. Photon 6 MV was applied to this technique with 30 segments, 50 segments, and 70 segments, repectively. Using Calculation Grid Resolution (CGR) 0.2 cm and 0.4 cm for resolution in the calculation of the dose. As well as the calibration of CT numbers (CCN) FBCT, CBCT, and the linear density are used as a correction CT number. The planar measurement for the evaluation of Gamma Index (DD 2% / DTA 2 mm, the passing rate of 90%) carried out at 100 cm SAD with the homogeneous and inhomogeneous material at a depth of 1.5 cm, 5 cm, and 10 cm, respectively. We obtained deviation average value of GI between CGR 0.2 cm and 0.4 cm using the homogeneous material on FBCT and CBCT modality ≤1.46% and ≤ 1:13%, respectively. As well as the material inhomogeneous deviation of ≤ 2.54% (FBCT) and ≤ 1.74% (CBCT). The deviation of the average GI value between FBCT with CBCT with CGR 0.2 cm respectively ≤ 1.95% (homogeneous) and ≤ 2.36% (inhomogeneous). Finally, the deviation of the average GI value between homogeneous and equivalent of homogeneous material is ≤ 0.80%. From the results obtained, that the Gamma Index can be influenced by the number of segments, modalities of CT, calibration of CT numbers, calculation grid resolution and depth of material.

, These

Studies

have

been

carried

out

to

evaluate

the

effect

of

a

homogeneous

and

inhomogeneous

material

on

IMRT

Technique

(Intensity

Modulated

Radiotherapy)

using

Fan

Beam

CT

(FBCT)

and

Cone

Beam

CT

(CBCT)

for

the

Gamma

Index

(GI).

The

Phillips

Pinnacle

treatment

plan

was

used

to

replan

5

patients

on

right

side

of

lung

cancer.

Photon

6

MV

was

applied

to

this

technique

with

30

segments,

50

segments,

and

70

segments,

repectively.

Using

Calculation

Grid

Resolution

(CGR)

0.2

cm

and

0.4

cm

for

resolution

in

the

calculation

of

the

dose.

As

well

as

the

calibration

of

CT

numbers

(CCN)

FBCT,

CBCT,

and

the

linear

density

are

used

as

a

correction

CT

number.

The

planar

measurement

for

the

evaluation

of

Gamma

Index

(DD

2%

/

DTA

2

mm,

the

passing

rate

of

90%)

carried

out

at

100

cm

SAD

with

the

homogeneous

and

inhomogeneous

material

at

a

depth

of

1.5

cm,

5

cm,

and

10

cm,

respectively.

We

obtained

deviation

average

value

of

GI

between

CGR

0.2

cm

and

0.4

cm

using

the

homogeneous

material

on

FBCT

and

CBCT

modality

≤1.46%

and

≤

1:13%,

respectively.

As

well

as

the

material

inhomogeneous

deviation

of

≤

2.54%

(FBCT)

and

≤

1.74%

(CBCT).

The

deviation

of

the

average

GI

value

between

FBCT

with

CBCT

with

CGR

0.2

cm

respectively

≤

1.95%

(homogeneous)

and

≤

2.36%

(inhomogeneous).

Finally,

the

deviation

of

the

average

GI

value

between

homogeneous

and

equivalent

of

homogeneous

material

is

≤

0.80%.

From

the

results

obtained,

that

the

Gamma

Index

can

be

influenced

by

the

number

of

segments,

modalities

of

CT,

calibration

of

CT

numbers,

calculation

grid

resolution

and

depth

of

material.

Key

words

:

Calculation

Grid

Resolution,

Calibration

of

CT

Numbers,

Cone]"

"ABSTRAKPasien spesifik QA pada teknik IMRT bertujuan untuk menjamin bahwa parameter-parameter penyinaran sesuai dengan perencanaan terapi. Dikarenakan terjadinya setup error pada pengukuran pasien spesifik QA pada teknik IMRT cukup tinggi, sehingga in house program QA akan berguna sebagai QA alternatif. Penelitian dilakukan menggunakan pesawat Varian Unique milik Rumah Sakit Cipto Mangunkusumo RSCM . Dynalogfile diperoleh dari tujuh kasus penyinaran. QA MLC dianalisa melalui parameter root mean square RMS error. Sementara itu, fluence map direkonstruksi berdasarkan informasi dari posisi leaf, posisi jaw, dan fraksional MU yang diperoleh berdasarkan data Dynalogfile setiap 50 ms. Tingkat konsistensi fluence map prediksi antar fraksi dievaluasi menggunakan gamma index. Kalkulasi gamma index antara fluence map sebenarnya dan fluence map prediksi dilakukuan untuk mengevaluasi adanya potensi error dari segmen-segmen yang dibentuk oleh posisi MLC. Kalkulasi dosis dilakukan berdasarkan data fluence map menggunakan metode modified Clarkson integration MCI . Hasil QA MLC pada seluruh kasus adalah kurang dari 0.5 mm untuk mean RMS error dan kurang dari 1 mm untuk max RMS error. Hasil ini menunjukkan bahwa posisi MLC saat penyinaran sesuai dengan perencanaan terapi. Evaluasi gamma dari fluence map sebenarnya terhadap fluence map prediksi pada pada seluruh sampel memiliki nilai rata-rata gamma dengan kriteria 2 , 2mm adalah 97.6 1.3 , sedangkan pada kriteria 3 , 3mm adalah 99.0 0.6 . Hasil ini menunjukkan bahwa tidak terdapat signifikan error pada segmen-segmen lapangan IMRT. Kalkulasi dosis menggunakan modified Clarkson Integration MCI berdasarkan fluens MU dibandingkan dengan kalkulasi dosis pada perencanaan terapi secara umum menghasilkan nilai evaluasi gamma dengan kriteria 4 ,4mm adalah lebih dari 95 pada lapangan kecil non split IMRT dan memiliki nilai lebih dari 90 untuk lapangan besar split IMRT .

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ABSTRACTThe purpose of IMRT patient specific QA is to ensure that delivery radiation parameters conform with treatment planning system. Since there are high probability of setup error in measurement IMRT patient specific QA, the in house QA program is useful as an alternative QA. This study aimed to investigate MLC QA and patient specific QA based on Dynalogfile. Varian Linear Accelerator at Cipto Mangunkusumo hospital have been used for this study. Dynalogfile were obtained from seven cases. The MLC QA were analyzed using the error RMS leaf parameter. Meanwhile, the fluence map were reconstructed based on the information of leaf position, jaw position, and fractional MU from Dynalogfile data every 50 ms. The consistency check of expected fluence map from fraction to fraction were calculated using gamma index evaluation. The gamma index evaluation between actual and expected fluence map were calculated to analyze the segment potential error caused by MLC positions. The dose were calculated using modified Clarkson integration based on fluence map data. The results of MLC QA from all cases are less than 0.5 mm for mean RMS error and below 1 mm for max RMS error. These results indicate that actual MLC position conform with treatment planning system. The results of 2 ,2mm and 3 , 3mm gamma evaluation from all samples between actual and expected fluence map are 97.6 1.3 and 99.0 0.6 . Those indicated that there is no IMRT segment significant error. Gamma pass rate results of 4 , 4 mm criteria between dose calculation using modified Clarkson integration based on fluence map and TPS calculation are above 95 for small IMRT field non split IMRT and above 90 for large IMRT field split IMRT . "

"Permitivitas relatif distribusi sel kanker relatif lebih tinggi dibandingkan dengan sel normal. Oleh karena itu, diagnosis kanker payudara dengan berbasis pengukuran kapasitansi memiliki peluang cukup besar. Dalam studi ini, diagnosis kanker payudara dilakukan dengan menggunakan ECVT (Electrical Capacitance Volume Tomography) yang akan memetakan distribusi 3D permitivitas relatif jaringan payudara. Pada penelitian ini dilakukan analisis selektivitas ECVT dalam membedakan kanker ganas (malignan) dan tumor jinak (benign). Pemindaian menggunakan ECVT pada 120 wanita yang mempunyai kelainan pada payudaranya berupa kista, tumor jinak dan kanker ganas berdasarkan identifikasi USG. Hasil menunjukkan bahwa nilai kapasitansi maksimum yang terdeteksi ECVT berkorelasi kuat dengan tingkat keganasan yang diidentifikasi USG. Hasil rekonstruksi ECVT menunjukan bahwa 89.55% dari semua data kanker ganas berada pada nilai kapasitansi maksimum diatas 0.3, sementara 94.4% kista dan tumor jinak berada pada kisaran dibawah 0.3. Hasil ini menunjukkan kelayakan ECVT dalam membedakan kanker ganas dan tumor jinak.

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In the previous study, has been developed a novel sensor for Electrical Capacitance Volume Tomography (ECVT) to map the distribution of tumor inside the human breast. The ECVT provides a volumetric image of permittivity distribution of the breast tissue, showing higher permittivity of abnormal tissue characterized with a simple cyst, a benign tumor or a malignant cancer as compared with normal breast. In this study, we evaluate the selectivity of the ECVT to differentiate malignant cancers from benign tumors. Serial cases involving 120 patients diagnosed with simple cysts, benign tumors or malignant cancers by Ultrasonography (USG) are scanned using the ECVT, and the images from both of the modalities are compared. It is found that the maximum voxel permittivity value of the reconstructed volumetric image is correlated strongly with the malignancy of the tumor identified by the USG. 89.55% of all malignant data reside above 0.3 in the normalized maximum permittivity value of the reconstructed ECVT image, while 94.4% of simple cyst or benign tumor is in the range below 0.3. This findings suggest the feasibility of the ECVT technique to differentiate the malignant cancer from benign tumor with relatively high selectivity."